Provider Demographics
NPI:1013284959
Name:MUKUND, RANJITHA (DMD)
Entity type:Individual
Prefix:
First Name:RANJITHA
Middle Name:
Last Name:MUKUND
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-1912
Mailing Address - Country:US
Mailing Address - Phone:908-835-0800
Mailing Address - Fax:908-835-8952
Practice Address - Street 1:7 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-1912
Practice Address - Country:US
Practice Address - Phone:908-835-0800
Practice Address - Fax:908-835-8952
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI204789001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice